Cilices were originally made from sackcloth or coarse animal hair so they would irritate the skin. Other features were added to make cilices more uncomfortable, such as thin wires or twigs. In modern religious circles, cilices are simply any device worn for the same purposes.

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The word cilice derives from the Latincilicium, a covering made of goat's hair from Cilicia, a Roman province in south-east Asia Minor.[8] The reputed first Scriptural use of this exact term is in the Vulgate (Latin) translation of Psalm 35:13, "Ego autem, cum mihi molesti essent, induebar cilicio." ("But as for me, when they were sick, my clothing was sackcloth" in the King James Bible). The term is translated as hair-cloth in the Douay–Rheims Bible, and as sackcloth in the King James Bible and Book of Common Prayer. Sackcloth can also mean burlap, but is often mentioned as a symbol of mourning and was probably a form of hairshirt.[citation needed]

There is some evidence, based on analyses of both clothing represented in art and preserved skin imprint patterns at Çatalhöyük in Turkey, that the usage of the cilice predates written history. This finding has been mirrored at Göbekli Tepe, another Anatolian site, indicating the widespread manufacturing of cilices. Ian Hodder has argued that "self-injuring clothing was an essential component of the Catalhöyük culturoritual entanglement, representing 'cleansing' and 'lightness'."[9]

In Biblical times, it was the Jewish custom to wear a hairshirt (sackcloth) when mourning (Genesis 37:34, 2 Samuel 3:31, Esther 4:1), but not in order to cause harm to oneself, which is forbidden in the Jewish religion. In the New Testament, John the Baptist wore "a garment of camel’s hair" (Matthew 3:4). Historically, some Christian denominations have worn sackcloth to mortify the flesh or as penance for adorning oneself.

In Dan Brown's novel The Da Vinci Code, one of the antagonists, an albinonumerary named Silas associated with the religious organization Opus Dei, wears a cilice in the form of a spiked chain around his thigh. The sensationalized depiction in the novel has been criticized for its inaccuracy in subsequent books and by Opus Dei itself, which issued a press release responding to the movie's depiction of the practice, claiming "In reality, they cause a fairly low level of discomfort comparable to fasting. There is no blood, no injury, nothing to harm a person's health, nothing traumatic. If it caused any harm, the Church would not allow it."[10][14]

In Molière's play, Tartuffe, the title character is shown to be a hypocrite when he wears a hair shirt with the hair lining facing outward, so that it can be seen, rather than felt.

The Marvel Comics character Robbie Baldwin commissioned the creation of a suit with 612 internal spikes to represent each person who died in an explosion for which he felt responsible, so that he would be reminded of their pain in everything he did.

In Gustave Flaubert's "The Legend of St. Julian the Hospitaler", Julian wears a hair shirt with iron spikes to do penance for his parricide.

In Flannery O'Connor's novel Wise Blood, the protagonist Hazel Motes is discovered by his landlady to be wearing a barbed wire cilice around his torso after he has blinded himself. She also finds that he has been walking miles each day with small rocks and glass in the bottom of his shoes.

In George R. R. Martin's series A Song of Ice and Fire, members of the militant branch of the Faith of the Seven known as Warrior's Sons and Poor Fellows commonly wear hair shirts. The High Septon appointed in A Feast for Crows known as the High Sparrow also wears one. Martin also mentions in his new book Fire and Blood that Aegon the Third, also known as Aegon the Unlucky or Aegon Dragonsbane, was said to wear a hair shirt under his clothing which added to his melancholy demeanour, probably due to the trauma he experienced during the Dance of the Dragons.

In the U.S. WGN America television series Salem, Increase Mather is shown wearing a metal cilice in season 1, episodes 10 and 11.

In Philippa Gregory's novel The King's Curse Katherine of Aragon and several other characters are described as wearing hair shirts. In her "Three Sisters, Three Queens" King James IV of Scotland wears a cilice consisting of "a circlet of metal rings around his waist".

In Parks and Recreation, Ron Swanson mentions a hair shirt when Leslie is being interrogated by government officials.[15]

^Neve, Juergen Ludwig (1914). The Augsburg Confession: A Brief Review of Its History and an Interpretation of Its Doctrinal Articles, with Introductory Discussions on Confessional Questions. Lutheran Publication Society. p. 150.|access-date= requires |url= (help)

^Bergen, Jeremy M. (31 March 2011). Ecclesial Repentance: The Churches Confront Their Sinful Pasts. A&C Black. p. 255. ISBN9780567523686. In fact, it was scandal of disunity within Methodism that led UMC leaders to address the issue of racism as the underlying cause. ... The petition for forgiveness proceeded on two distinct but interrelated levels. Each of the approximately 3,000 persons in the assemble was called to silent personal confession of the sin of racism before God, publicly symbolized by receiving ... sackcloth ... and the imposition of ashes.

^ abYates, Nigel (11 June 2014). Eighteenth Century Britain: Religion and Politics 1714-1815. Routledge. p. 87. ISBN9781317866480. The Evangelical revival in Scotland encouraged both much stricter conditions being placed on admission to Holy Communion and the maintenance of traditional discipline within the established church. ... Lesser transgressors could be ordered by the kirk session to stand before the congregation for up to three Sundays, sometimes wearing sackcloth, and publicly acknowledge their sins before 'being subjected to a "rant" from the minister'.

^Beaulieu, Geoffrey of; Chartres, William of (29 November 2013). The Sanctity of Louis IX: Early Lives of Saint Louis by Geoffrey of Beaulieu and William of Chartres. Cornell University Press. p. 89. ISBN9780801469145.